The present invention relates to a suture anchoring and tensioning device for use with sutures in surgical procedures.
In surgical invasive procedures sutures are commonly used to close incisions and to reunite damaged tissue. Typically, the sutures are maneuvered and passed through the affected tissue and the free ends of the sutures are individually tied together by the surgeon. In most surgical incisions, the surgical site area is sufficiently exposed to permit the surgeon to access and quickly tie the suture with a surgical knot by his or her hand. However, in other surgical procedures, such as endoscopic procedures, lapaoroscopic procedures, arthroscopic procedures and the like, the suturing site is inaccessible to the surgeon""s hands. As a result, the surgeon must tie each of the suture ends into a knot at a location remote from the suturing site, and then manipulate suitably configured instruments for sliding the surgical knot to the suturing site of the incision. Conventionally, most surgical sutures are secured with surgical knots that are somewhat cumbersome and slow to tie. Further, when suturing, knot tying is one of the more time-consuming steps in the suturing process of the surgical procedure. Also, it is noted that knots are weak points in a suture. That is to say, when a knotted suture is broken from applied tension (assuming the suture is otherwise free from imperfections) the suture will break at the knot.
There remains a need for the elimination of knot tying from surgical procedures which would significantly reduce the duration of a particular surgical operation by the use of a suture anchoring and tensioning device in combination with surgical sutures. Additionally, this suture anchoring device would apply sufficient tension to the in-placed sutures in order to restrict any movement of the sutures at the surgical site. Further, the elimination of tying of surgical knots with regard to minimally invasive surgical operations is needed because of the increased difficulty and extended time involved in tying knots by the surgeon in confined surgical areas within the patient""s body.
Suture locking devices such as suture clips, surgical fasteners, hinged clips, suture terminating devices, hemostatic clips, and suture fixation devices of various configurations, designs, structures and materials of construction are well known in the prior art. For example, U.S. Pat. No. 6,165,204 to Levinson, et al. discloses a shaped suture clip having a pair of plates joined together at one end to form a corner point (vertex) having an acute angle and having, at the other end, a pair of hook members, so as to clamp the suture in place. The opening of the clamp is slightly smaller than the diameter of the suture, thereby resulting in a pressure hold when the suture is passed through the suture clip. This suture clip will only clamp one end of the suture in place.
U.S. Pat. Nos. 5,474,572 and 5,645,553 disclose the use of a hinged clip that snaps closed after the suture threads are placed within the (jaws) holding members. The hinge clip is then snapped into place such that the suture is held transversely across the holding members, thus locking the suture in place. There is a possibility of not achieving a good set, as the snap may not have been properly actuated, or that the snap may have released.
U.S. Pat. No. 6,001,110 to Adams discloses a hemostatic clip having pseudoelastic properties at body temperature. The pseudoelastic NITINOL(copyright) clips are used to cause hemostatsis of blood vessels located along the gastrointestinal tract. The hemostatic clip has a first configuration that is useful for ligating blood vessels and is deformed to a second configuration to facilitate placement to a desired location within the body.
U.S. Pat. No. 6,106,545 to Egan discloses a suture tensioning and fixation device, which includes the combination of a plurality of suture retaining elements and a suture thread. The suture thread engages portions of each of the retaining elements, such that the suture thread is adapted to functionally engage the retaining elements for holding the interwoven suture segments in place for a knotless joint.
U.S. Pat. No. 6,066,160 to Colvin, et al. discloses a suture terminator device for enhanced tissue securing used in minimally invasive surgery. The suture securing device includes a pair of locking apertures for engaging a portion of a suture at its threaded end.
WO Publication No. 99/62406 to Schaller, et al. discloses a coalescent surgical clip that uses a plurality of NITINOL(copyright) spring-coiled loops to achieve the desired suturing results in an anastomosis surgical procedure. However, because the NITINOL(copyright) spring-coiled loops have a set mechanical property, the surgeon does not get the feel for the strength of the suturing in the anastomosis procedure.
In the foregoing circumstances, it is an object of the present invention to provide a suture anchoring and tensioning device that allows the surgeon to feel the amount of tension applied to the suture.
Another object of the present invention is to provide a suture anchoring device that eliminates knot tying by the surgeon performing the surgical procedure.
Yet another object of the present invention is to provide a suture anchoring device that is small so as not to interfere with adjacent suture ties.
A still further object of the present invention is to provide a suture anchoring and tensioning device that is simple to use, and would require only minimal training by the surgeon.
In accordance with the present invention, there is provided a novel suture anchoring device which overcomes the problems and shortcomings of the prior art devices discussed hereinabove. More particularly, the novel suture anchoring device includes a resilient member, which is biased into a normally coiled configuration. The resilient member is adapted to hold a suture such that the suture becomes entwined within the resilient member as the resilient member moves from an uncoiled configuration to its normally coiled configuration. The resilient member forms a tight spiral when it is in its coiled configuration, thereby tensioning the entwined suture. In one embodiment, the resilient member is made from a superelastic material, such as a nickle titanium alloy, having a memory shape. In an alternate embodiment, the resilient member is made from a polymeric plastic material having a memory shape.